Evidence map›Paper›PMID 38758243›Full record

ArticleEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2024

The risk of free flap revision and subsequent medical costs in patients with hypopharyngeal cancer.

Chun-Hsien Ho, Sheng-Dean Luo, Wei-Chih Chen, Tai-Jan Chiu, Yu-Ming Wang, Shao-Chun Wu, Yao-Hsu Yang, Shau-Hsuan Li, Spencer Chia-Hao Kuo, Ching-Nung Wu

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Article in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

10 authors.

Chun-Hsien HoDepartment of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, No. 123, Dapi Rd., Niaosong District, Kaohsiung, 83301, Taiwan.
Sheng-Dean LuoDepartment of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, No. 123, Dapi Rd., Niaosong District, Kaohsiung, 83301, Taiwan.
Wei-Chih ChenDepartment of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, No. 123, Dapi Rd., Niaosong District, Kaohsiung, 83301, Taiwan.
Tai-Jan ChiuGraduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Yu-Ming WangDepartment of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Shao-Chun WuDepartment of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Yao-Hsu YangSchool of Traditional Chinese Medicine, Chang Gung University College of Medicine, Taoyuan, Taiwan.
Shau-Hsuan LiDepartment of Hematology-Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Spencer Chia-Hao KuoDepartment of Plastic Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Ching-Nung WuDepartment of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, No. 123, Dapi Rd., Niaosong District, Kaohsiung, 83301, Taiwan. taytay@cgmh.org.tw.ORCID http://orcid.org/0000-0001-9397-0986

Funding

Kaohsiung Chang Gung Memorial Hospital CORPG8L0481
6 · The paper itself

Abstract

backgroundFew studies have examined the preoperative risks and healthcare costs related to free flap revision in hypopharyngeal cancer (HPC) patients.

methodsA 20-year retrospective case-control study was conducted using the Chang Gung Research Database, focusing on HPC patients who underwent tumor excision and free flap reconstruction from January 1, 2001, to December 31, 2019. The impacts of clinical variables on the need for re-exploration due to free flap complications were assessed using logistic regression. The direct and indirect effects of these complications on medical costs were evaluated by causal mediation analysis.

resultsAmong 348 patients studied, 43 (12.4%) developed complications requiring re-exploration. Lower preoperative albumin levels significantly increased the risk of complications (OR 2.45, 95% CI 1.12-5.35), especially in older and previously irradiated patients. Causal mediation analysis revealed that these complications explained 11.4% of the effect on increased hospitalization costs, after controlling for confounders.

conclusionsLower preoperative albumin levels in HPC patients are associated with a higher risk of microvascular free flap complications and elevated healthcare costs, underscoring the need for enhanced nutritional support before surgery in this population. LEVEL OF EVIDENCE: 3:

Indexed as

Free Tissue FlapsHypopharyngeal NeoplasmsPostoperative ComplicationsReoperationAdultAgedCase-Control StudiesFemaleHealth Care CostsHumansMaleMiddle AgedPlastic Surgery ProceduresRetrospective StudiesRisk FactorsTaiwanAlbuminFree flap complicationsHypopharyngeal cancerMedical expenditures

Identifiers

PMID38758243

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